What a Medical Examiner Office Is
A medical examiner office is a government agency that investigates deaths that happen under unusual, suspicious, or unclear circumstances. The medical examiner is a doctor — usually a pathologist — who performs autopsies, reviews medical records, and determines the cause and manner of death. Unlike a coroner (an elected official who may or may not have medical training), a medical examiner is always a licensed physician.
The office exists in most urban and suburban counties across the United States. In rural areas, you may have a coroner instead, or a coroner who works with a medical examiner. The medical examiner's job is to answer the question: what actually killed this person, and under what circumstances? That answer goes into a death certificate, which is then filed with the state vital records office.
You don't contact a medical examiner office to request their services. Police, hospitals, nursing homes, or family members report a death, and the office decides whether to take the case. If they do, they control the body and the investigation until they release both.
Key Takeaways
- A medical examiner is a physician employed by the county who investigates deaths that are sudden, violent, suspicious, or medically unexplained.
- The office performs autopsies, determines cause of death, and issues the official death certificate — you cannot get one until their investigation closes.
- Police or hospital staff report deaths to the medical examiner; you do not contact them directly unless you are a family member with questions about a specific case.
- The investigation can take anywhere from a few days to several weeks, depending on whether an autopsy is needed and whether toxicology results are pending.
- Once the investigation is complete, the medical examiner releases the body to a funeral home and issues a final death certificate to the family.
When a Death Goes to the Medical Examiner
Not every death is investigated by the medical examiner. Deaths from known medical conditions in a hospital or hospice, where the person was under a doctor's care, usually do not. The attending physician signs the death certificate based on the medical record.
A death goes to the medical examiner if it is sudden and the cause is not obvious, if it is violent (homicide, suicide, accident), if it is suspicious, if it happens in custody or during police contact, or if the person had no doctor and no one knows why they died. A death at home with no recent medical care almost always goes to the medical examiner, even if the person was elderly.
The decision to investigate is made by the medical examiner's office, not by the family or the police. Police will call the office and describe the circumstances. The medical examiner then decides whether to take the case. If they do, they take custody of the body when ready.
What Happens During a Medical Examiner Investigation
Once the office takes a case, they will usually perform an autopsy — a surgical examination of the body to look for the cause of death. The autopsy is done in the medical examiner's facility, not at a hospital or funeral home. It takes a few hours, and the body is then released to a funeral home of the family's choice.
During the autopsy, the medical examiner collects tissue samples, blood, and other specimens. These go to a toxicology lab to test for drugs, alcohol, or poisons. Toxicology results are the main reason investigations take time — they can take two to four weeks depending on the lab's workload.
The medical examiner also reviews the person's medical history, any police reports, witness statements, and scene photographs. They may order additional tests like imaging or genetic testing if the cause is still unclear. Once all results are back, the medical examiner writes a report and determines the cause of death (the disease or injury that killed the person) and the manner of death (natural, accident, suicide, homicide, or undetermined).
How Long the Investigation Takes
A straightforward case — a person found at home with no signs of trauma, where the autopsy shows a clear cause like a heart attack — may close in three to five days. The family can then get a death certificate and arrange the funeral.
A case that requires toxicology testing usually takes two to four weeks. A case with suspicious circumstances, multiple injuries, or unclear findings can take longer. Some cases remain open for months if the medical examiner is waiting for police to finish their own investigation (in a homicide, for example).
You can call the medical examiner's office to ask about the status of a case, but they will only give information to the next of kin or an authorized representative. Have the person's full name and date of death ready. The office will tell you whether the investigation is still open and, if it is closed, when the death certificate will be available.
Getting the Death Certificate
The medical examiner does not issue the death certificate directly to the family. Once the investigation is complete, the medical examiner sends the findings to the state vital records office (or county clerk, depending on your state). That office then issues the official death certificate.
You can order a death certificate from the vital records office once the medical examiner has released their findings. Some states allow you to order it online; others require you to mail a form or visit in person. The cost varies by state but is usually between $10 and $30 per copy. You will need multiple certified copies for insurance claims, bank accounts, and other purposes.
If the medical examiner's investigation is still open, the vital records office cannot issue a death certificate yet. You will have to wait. Some families ask the funeral home to check the status; funeral homes often have direct contact with the medical examiner's office and can get answers faster than a family member calling.
What Information the Medical Examiner Releases
The medical examiner's findings are public record in most states, but the level of detail released varies. The cause and manner of death are always public. Autopsy reports, toxicology results, and scene photographs may or may not be, depending on state law and whether the case is still under police investigation.
If you are the next of kin, you can request the full autopsy report and other documents from the medical examiner's office. You may have to pay a copying fee. If the case is still under investigation by police, some information may be withheld temporarily.
If you are not family but have a legitimate reason to know the cause of death (you are a journalist, a researcher, or you have a legal claim), you can file a public records request. The medical examiner's office will tell you what they can release under your state's public records law.
Releasing the Body to a Funeral Home
Once the autopsy is complete, the medical examiner releases the body to a funeral home. The family does not choose the funeral home in advance — the medical examiner's office will ask the family which funeral home they want, and the office contacts that home directly.
If the family has not chosen a funeral home, the medical examiner's office may hold the body for a short time while the family decides. Some offices have a list of funeral homes they work with regularly. The funeral home then takes custody and can proceed with embalming, viewing, or cremation, depending on the family's wishes.
The medical examiner does not charge a fee for the autopsy or the investigation. However, the funeral home will charge for their services, and if the body has been held for a long time, there may be storage fees. These costs are the family's responsibility.
Frequently Asked Questions
Can I request that no autopsy be done?
No. If the medical examiner takes a case, an autopsy is mandatory. You cannot refuse it or request that it not happen. However, if the cause of death is already clear from the circumstances and medical history, the medical examiner may decide not to perform a full autopsy — they can sometimes determine cause of death from the external examination and medical records alone.
How do I find out which medical examiner office handles my county?
Search online for "[your county name] medical examiner" or "[your county name] coroner." Most offices have a website with their address, phone number, and hours. If you cannot find one, call your county sheriff's office or the county clerk — they can tell you which office investigates deaths in your area.
What if I disagree with the cause of death the medical examiner determined?
You can request a second opinion from another pathologist, though you will have to pay for it. You can also file a complaint with the medical examiner's office or the state medical board if you believe the investigation was inadequate. Some families hire a private pathologist to review the autopsy report and photographs.
Will the medical examiner talk to me about the findings before the death certificate is issued?
Yes. Once the investigation is complete, you can call the medical examiner's office and ask to speak with the investigator or the medical examiner. They will explain the findings and answer questions. Some offices do this routinely; others only if you ask. It is worth calling to request a conversation, especially if the death was unexpected.
How long can the medical examiner hold a body?
There is no set legal limit in most states, but medical examiners try to release bodies within a few days of the autopsy. If the investigation is still open and waiting for test results, the body may be held longer. If you need the body released for religious or cultural reasons, tell the medical examiner's office — they may be able to expedite the release or work with you on timing.